Value of alpha-fetoprotein and clinical characteristics in patients with liver neoplasm

This article aimed to investigate the value of α-fetoprotein (AFP) for the diagnosis of hepatocellular carcinoma (HCC) and to evaluate the relationship between AFP and various clinical variables of HCC comprehensively. A retrospective study of postoperative patients diagnosed with liver neoplasm fro...

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Bibliographic Details
Published in:Neoplasma 2014, Vol.61 (2), p.218-224
Main Authors: Xu, J B, Qi, F Z, Xu, G, Chen, G F, Qin, L X, Zhang, J H
Format: Article
Language:English
Subjects:
Adult
alpha-Fetoproteins
Biomarkers, Tumor - blood
Carcinoma, Hepatocellular - blood
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - pathology
Female
Hepatitis B - blood
Hepatitis B Core Antigens - blood
Hepatitis B Surface Antigens - blood
Humans
Liver Neoplasms - blood
Liver Neoplasms - diagnosis
Liver Neoplasms - pathology
Logistic Models
Male
Middle Aged
ROC Curve
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Summary:This article aimed to investigate the value of α-fetoprotein (AFP) for the diagnosis of hepatocellular carcinoma (HCC) and to evaluate the relationship between AFP and various clinical variables of HCC comprehensively. A retrospective study of postoperative patients diagnosed with liver neoplasm from two Chinese centers was enrolled in our study.A total of 3050 patients were included. The best cut-off point of AFP for the diagnosis of HCC was 20ng/ml with ideal sensitivity (69.74%), specificity (91.18%), LR (4.12) and YI (0.61). Non-HBV infection patients showed the highest specificity (94.44%) but lowest sensitivity (60.13%). In HBV infection. Patients, HBsAg, HBeAb, and HBcAb positive patients had the highest sensitivity (79.55%) and specificity (58.49%). AFP levels increased significantly in symptomatic patients (p=0.011). Those patients with tumor sizes ≥10cm had much higher serum AFP level compared with smaller tumors ones (p=0.014). AFP levels increased remarkably in patients with vascular invasion (p=0.015). Stepwise logistic regression showed tumor size (≥10cm) was an independent predictor of elevated AFP (OR=2.743, 95%CI: 1.167-6.447, P=0.021). The best discriminating AFP value for the diagnosis of HCC is 20ng/ml; HBsAg, HBeAb and HBcAb positive patients have the optimal sensitivity and specificity; tumor size ≥ 10cm is an independent predictor of elevated AFP.
ISSN:0028-2685
DOI:10.4149/neo_2014_028